A study conducted by UT Southwestern’s Division of Digestive and Liver Diseases, in conjunction with the Simmons Cancer Center and the Moncrief Cancer Institute, in collaboration with JPS Health Network suggests changes be made to the standard of care strategy for colorectal screenings. The study, published in the Aug. 5 edition of JAMA Internal Medicine, looked at nearly 6,000 North Texas patients. The findings showed that participation rates soared depending on the screening method offered and how patient outreach was done.
The results also suggest that a noninvasive colorectal screening approach, such as a fecal immunochemical tests (FIT) might be more effective in prompting participation in potentially lifesaving colon cancer screening among underserved populations than a colonoscopy, a more expensive and invasive procedure. FIT, a quick test that requires no special preparation, detects small amounts of hidden blood in a patient’s stool sample. Completed tests are then mailed to a laboratory for analysis. The findings presented in the published paper showed that with the help of a mail campaign, FIT participation tripled, and colonoscopy participation doubled in the study sample.
In the investigation, uninsured patients at John Peter Smith (JPS) Health Network in Fort Worth ages 54 to 64 years and not up to date with their screenings were mailed invitations to use and return a no-cost FIT, or to schedule a no-cost colonoscopy. Both groups also received follow-up telephone calls to promote testing.
“The study suggests that the best approach to offering and delivering screening to underserved populations may be through FIT,” said senior author Dr. Celette Sugg Skinner, associate director of population science and cancer control for the Harold C. Simmons Cancer Center in a news release. “Questions for the future are whether superior participation can be maintained in the FIT group [because the test must be repeated every year] and how adherence rates will impact overall screening effectiveness and cost.” Study authors say the findings raise the possibility that cost-effective, large-scale public health efforts to boost screening may be more successful if noninvasive tests, such as FIT, are offered along with colonoscopy screenings. Other UT Southwestern researchers involved were Dr. Ethan A. Halm, chief of the division of General Internal Medicine; Dr. Chul Ahn, professor of clinical science; Dr. Keith Argenbright, director of the Moncrief Cancer Institute; Dr. Jasmin Tiro, assistant professor of clinical science; Dr. Sandi Pruitt, assistant professor of clinical science; Luisa Valdez, clinical data specialist at the Simmons Cancer Center; Liyue Tong, biostatistical consultant II in clinical science; and Zhuo Geng, a student at UT Southwestern Medical School. The study’s first author is Dr. Samir Gupta, associate professor of clinical medicine at UCSD. Scientists at the Medical University of South Carolina also participated.
Primary funding was provided by the Cancer Prevention and Research Institute of Texas . Additional funding was provided by National Institutes of Health grants.